Research published today on bmj.com reports that women who lie on their backs for fifteen minutes after artificial insemination have a “significantly higher” chance of getting pregnant than women who move around straight after treatment.

Lead author Dr Inge Custers from the Academic Medical Centre in Amsterdam and colleagues are now recommending that all women undergoing intrauterine insemination should be offered fifteen minutes of immobilization after the procedure.

One of the most common methods of fertility treatment is intrauterine insemination with or without ovarian hyper stimulation. It is provided globally. Although some earlier small scale studies have investigated links between immobilization and the success of intrauterine insemination, this study is the first large scale trial of its kind.

Approximately 400 couples participated in the study. About half of them were asked to lie down for fifteen minutes after intrauterine insemination. The other half were allowed to move around instantly after the procedure. The results show that “the ongoing pregnancy rate was significantly higher in the immobilization group: 27% percent (54) compared to 18 percent (34).”

The authors observe it is not clear why immobilization improves the success of intrauterine insemination. They speculate that moving around after treatment might cause leakage.

Dr Custers claims that all women undergoing intrauterine insemination should be allowed to lie down for fifteen minutes after treatment and that “Although immobilization takes more time and occupies more space in busy rooms, the intervention will be economic in the long run, as pregnant patients will not return in subsequent cycles.”

In an associated editorial, Professor William Ledger from the University of Sheffield, remarks that while Custers’ research is promising, there is a need for further studies. He suggests that units should perform their own evaluation to experiment the hypothesis in the “real world” and that “if successful, more couples could be spared the rigorous and costly process of in vitro fertilization.”

“Immobilisation versus immediate mobilisation after intrauterine insemination: randomised controlled trial”
Inge M Custers, PhD student and registrar, Paul A Flierman, fertility doctor, Pettie Maas, fertility doctor,Tessa Cox, fertility doctor, Thierry J H M Van Dessel, gynaecologist, Mariette H Gerards, fertility doctor, Monique H Mochtar, gynaecologist, Catharina A H Janssen, gynaecologist, Fulco van der Veen, professor of gynaecology and fertility specialist, Ben Willem J Mol, professor of gynaecology
BMJ 2009; 339:b4080
doi:10.1136/bmj.b4080

“Supine positioning after intrauterine insemination”
William L Ledger
BMJ 2009; 339:b4274
bmj.com

Written by Stephanie Brunner (B.A.)